Abstract 10996: Clinical Characteristics and Outcomes of Infective Endocarditis Among Intravenous Drug Abusers - A Single-Center Experience

Abstract

Introduction: There are limited data regarding intravenous drug abuse (IVDA) associated with infective endocarditis (IE). The study aimed to compare IVDA to non-IVDA-associated IE regarding the differences in clinical profile, microbiology, echocardiography, and clinical outcomes among patients admitted with IE. Methods: 90 patients from January 2019 to December 2021 who met the Modified Duke ‘‘definitive’’ criteria for IE were included. Demographic, clinical, and laboratory data were collected. All patients underwent transthoracic echocardiography and transesophageal echocardiogram whenever indicated. In-hospital morbidity and mortality were reported. Results: Among the 90 patients included, 24 (26.7%) had a history of IVDA. IVDA-group were younger (27 vs 40 years, P<0.0001), males (95.8% vs 69.7%, P=0.01), and more likely to have concomitant HCV and HIV infections compared to non-IVDA-group (50% vs 3%, P<0.0001). Methicillin-resistant staphylococcus aureus (MRSA) percentage was higher in IVDA-group (54.2% vs 16.7%, P= 0.0004). Tricuspid value was the most common valve (79.2%) affected in IVDA-group whereas mitral followed by aortic valves were most commonly involved in non-IVDA-group (43.9% and 31.8% respectively). Embolic events at admission were more frequent in IVDA-group (83.3% vs 15.2%, P<0.0001). Septic shock and embolic events (58.3%, 37.5% consecutively) are the most common causes of in-hospital morbidity among IVDA-group. In-hospital mortality was significantly higher among IVDA-group compared to non-IVDA-group (58.3% vs 25.8%, P=0.04). Conclusion: The demographic, microbiological, and echocardiographic profile is quite different in IVDA and non-IVDA-group. Larger studies are required to confirm these data, especially in low- and middle-income countries.